BIG OPERATION

Queensland’s $1.8b Sunshine Coast University Hospital (SCUH) saw its first patients in March this year and was officially opened on 19 April 2017. The hospital opened with 450 beds, and will expand to its built capacity of a 738-bed facility by 2021. Its construction was a massive undertaking in every respect, and part of the project was a truly impressive (and award winning) $15m audiovisual fitout that encompassed a total of 144 rooms.

To get a feel for the project, I spoke first with Andrew Harpur who led the audiovisual consulting team from CHW Consulting. He explained that CHW was engaged by Queensland Health to undertake a comprehensive design review of the existing audiovisual proposal.

As with many large-scale projects, the SCUH audiovisual brief was submitted a number of years ago and contained a high level design comprising a number of what are now legacy systems, such as VGA and composite video.

“From a Queensland Health perspective,” Andrew explained, “it wanted a contemporary system, so we validated whether it was still compliant. We undertook three months of detailed user workshops with all of the key stakeholders to validate their requirements for AV solutions in the spaces it required.”

Those spaces were quite extensive and varied, comprising 25 clinical spaces such as operating theatres, extensive educational facilities including simulation labs, lecture theatres and a 350-seat auditorium plus more than 70 meeting rooms ranging from simple spaces right through to twin Health Emergency Operations Centres, capable of disaster management for the entire Sunshine Coast region.

The workshops proved to be a crucial part of the process and often involved a very large cast. “We had everyone from Heads of Surgery to the Theatre Nurses who operate the technology,” Andrew recalled. “We had the IT representatives and, because it is a teaching hospital, we had all the universities and tertiary representation as well as clinical planners, and the other Queensland Health departments such as Telehealth.

“And it was quite apparent,” Andrew continued, “that there was a big gap between what users were expecting and what had currently been documented. It certainly assisted with the process, having those stakeholders on board — and having their buy-in was essential.”

GOODBYE ANALOGUE

Once the review was complete, Queensland Health engaged CHW as its consultant to update and go to market with a revised design for all of the audiovisual systems within SCUH.

The first task in the redesign was to reassess whether analogue signals were still needed. “It’s not just the cabling costs or the connector costs for the AV. Obviously, we need bigger switches, but then we need to look at things like pendants and joinery and cable access. In some instances, by being able to shrink pendant sizes because we’ve got fewer connectors, saves thousands or tens of thousands of dollars.”

So, while VGA inputs could be handled (where needed) using multi-format input plates, the entire design was simplified to an all-digital system based on AMX DXLink transmitters and AMX Enova DGX matrix switchers, with switcher frame sizes right up to 64×64. Going all-digital helped in other ways, too. Wherever medical equipment is to be connected to the audiovisual system (for monitoring, transmission or recording) it has to be electrically isolated to ensure safety. “One of the best ways to do that is with fibre,” Andrew explained. “What we did is to standardise the interconnection between all of the roll-about ‘equipment stacks’ they bring in and out of the theatres (that could be an ultrasound or an endoscopy machine, an image intensifier, or a laparoscopic stack for instance).” Fortunately, the AMX DGX system makes that easy with a range of fibre transmitters as well as Cat6 connections. “We implemented that through the use of opticalCON connectors — the broadcast version that’s quite tough, and can handle a roadie throwing a road case on it.”

Sunshine Coast University Hospital: AV Facts & Figures

Total Project Cost: $1.8 billion

Beds (at opening): 450

AV Budget: $15 million

Total AV Equipped Rooms: 144

O/Rs /Procedure Labs 25

Meeting Rooms 70

Simulation Spaces 8

THEATRE: MACHINES THAT GO PING

As the facility is a teaching hospital, the clinical rooms (such as operating theatres) can be quite complex as they cater not only to medical and surgical staff, but also to students who may be observing locally or remotely. Andrew described a typical operating theatre:

“There are two NEC 75-inch displays on opposite walls, depending on which way the surgeon wants to stand. Then we have two pendant-mounted Sony clinical monitors the surgeon can bring in nice and close in front of them. Selected spaces also have full recording facilities using Metus INGEST recording onto the data centre storage servers. There are three to four cameras in each of the spaces to facilitate both the recording and the Telehealth requirements. Every theatre has a Cisco CX80 videoconference codec and through the Telehealth network, they can videoconference to just about any other space with a Cisco Codec — lecture theatres, conference rooms, training rooms auditoriums and other operating theatres.”

As well as inputs from the medical equipment (such as endoscope cameras) the larger theatres are fitted with four Sony SRG300 broadcast PTZ cameras, alongside a camera right in the middle of the LED operating theatre light.

Andrew noted: “The feedback we’ve had from the users is that they are very impressed with the quality of those cameras and the whole signal chain. We’ve kept everything in HD resolution at 60 frames — as high as we possibly can through the system. We obviously had to ensure the signal chain was capable of maintaining that quality right the way through.”

INTEGRATION: 12 GUYS ON CAMPUS

Meanwhile, Rutledge AV had won the tender for the audiovisual installation, having previously worked with the builder (Lend Lease) on the Gold Coast University Hospital, completed a few years earlier. However, this was a much bigger installation contract, as Corey Cupples, onsite Project Manager for Rutledge AV, explained: “We had 12 guys onsite plus about six office staff working on it pretty much full time, across engineering, programming, commissioning, and pre-commissioning,” he recalled.

The clinical spaces posed some interesting installation challenges not found on more routine jobs. “All the walls are lead lined which means all cabling needs to come through conduits and, once in, they couldn’t be altered,” Corey noted.

In such a complex project, it was important for Rutledge AV to have its teams be organised, flexible and agile. “It’s definitely a challenge working with a builder and only having a single narrow window of time to get cables in. Everything moved extremely quickly from a builder’s point of view with everyone jumping in and out.

“We pre-commissioned a lot of equipment before it rolled on to site,” Corey continued. “We pre-built all the racks, loaded the programs, commissioned and then rolled them into the rooms.”

EDUCATION: SIM CITY

As you would expect at a modern teaching hospital, training facilities are a major focus. A separate building houses the educational facilities which include six fully-equipped simulation suites where medical scenarios can be created, recorded and later analysed as a learning aid for medical students. There is a full operating theatre simulation and an eight-bed simulated hospital ward as well as a simulated birthing suite, resuscitation bay and intensive care unit. Andrew Harpur regards these spaces as second to none in Australia, featuring multi-channel video, audio and data streaming, recording and replay facilities capable of capturing every aspect of the simulation from multiple angles.

Other teaching facilities include a 350-seat auditorium with its own video production centre. Up to seven cameras can be used for streaming or live videoconferencing and each of the cameras can be iso-recorded for later post production using a Grass Valley EDIUS editing system.

But wait, there’s more (too much more to cover in one article!), including meeting and boardrooms; other clinical spaces ranging from procedure labs to multidisciplinary training rooms, audiology and autopsy facilities plus mental health spaces.

Operations: One of the SCUH rack rooms, including a rack of tvONE C2-6104A four-window multiviewers, used to enable multiple images to be recorded or used for video conferencing as a single source. The inputs can include (depending on the room), cameras, medical equipment outputs (ie. endoscopy, haemodynamic, laparoscopic, real-time scanning equipment), medical imaging, simulation equipment, patient information etc.

POST OP

With so much new technology, post installation support is clearly vital to a smooth transition to full operation. To address this, Ricky Cook, Rutledge AV’s Queensland State Manager, explained how Rutledge implemented a Service Level Agreement to provide a Resident Technician on-site.

“It was vitally important to have somebody onsite to give the users confidence that they can make one phone call and hear from the resident technician: ‘yes I’m on my way, I’m here to help you’. And it’s also important to provide ongoing training, so if people move and somebody new comes in, they can be taught how to use the equipment.”

After such a massive, long-term project, both designer and integrator were in agreement that communication had been key. “It seemed pretty seamless,” noted Ricky, “everybody valued everybody’s comments.”

From CHW’s perspective, Andrew Harpur agreed: “This was one of those cases where it just worked; and it shows that it worked! At the end of the day there were very few outstanding issues; we went live and it all worked. It’s one to show that the close engagement of a design consultant certainly pays dividends.”